• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Care Conference Stroke
 

Care Conference Stroke

on

  • 242 views

 

Statistics

Views

Total Views
242
Views on SlideShare
242
Embed Views
0

Actions

Likes
0
Downloads
1
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Care Conference Stroke Care Conference Stroke Presentation Transcript

    • At the end of this session, you will be able to :  State the definition of stroke.  List the etiology of stroke.  Identify the pathophysiology of stroke.  State the sign & symptom of stroke.
    • LEARNING OBJECTIVES cont.  Identify the complication of stroke.  Understand regarding treatment of stroke.  Identify the nursing intervention & appreciate the nursing care for stroke patient.
    • PATIENT’S PROFILE  MRS. M  FEMALE  75 YEARS OLD  HOUSEWIFE
    • PATIENT’S PROFILE  TROLLEY  ANXIOUS  ALLERGICS - NIL  D.O.A 9/4/12 @ 1015 Hrs
    • Mrs M was admitted to 5XX-1 with complaint of right sided weakness, slurred speech, numbness right arm, giddiness, dysphagia, nausea and vomiting X 1/7.
    • Doctor = Dr AA Diagnosis 1.Stroke 2.High Cholesterol
    • PATIENT’S PROFILE  MEDICAL HISTORY  Nil  SURGICAL HISTORY  Left eye removal of cataract (2 years ago)  Right eye removal of cataract (1 year ago)  FAMILY MED HISTORY  HPT (mother)
    • CURRENT MEDICATION  Nil
    • VITAL SIGN  TEMPERATURE  BLOOD PRESSURE  PULSE  RESPIRATION  PAIN SCORE  Dextrosmeter  Weight : : : : : : 36.8˚C 170/100mmHg 88 bpm 18 bpm 1 8.2 mmol/L : Unfit
    • ACTIVITY DAILY LIVING  Having difficulty in swallowing  Loss of appetite, nauseated and vomiting  Anxious and asking many questions.  Need assistance in ADL and personal hygeine  On pampers
    • PHYSICAL EXAMINATION
    • S/B Dr AA in A&E  17K  CT BRAIN  IV Drip D5% slow  Low fat diet  KIV anti HPT  Dietician advice  ROM exercise
    • ISCHEMIC STROKE • Occurs when blood clot or thrombus formed and blocked blood flow to part of the brain.
    • HAEMORRHAGIC STROKE • Occurs when blood vessel ruptured and blood fills space between brain and skull (subarachnoid haemorrhage) or when a defective artery burst and blood fills the surrounding tissue (cerebral haemorrhage).
    • WHAT pressure High blood CAUSES IT?  High cholesterol  Aging  Stress  Cardiovascular disease  Smoking and alcohol  Diabetes 
    • RISK FACTORS • Family history • Age over 40 • High BP • High cholesterol • Smoking
    • RISK FACTORS • African American or Asian • Male • Diabetes • Obesity • Cardiovascular disease • Stress
    • RISK FACTORS • Previous stroke or TIA • High level of homocysteine (amino acid) in blood • Birth control or hormonal therapy • Cocaine usage • Alcohol
    • COMPLICATION • Paralysis • Vision loss • Difficulty speaking or swallowing • Memory loss • Death
    • 17K • ESR - 56 (0 – 20 mm/hr) • Neutropil - 79.9% (40 – 75%) • Lymphocyte - 16.0% (20-45%) • Glucose - 6.9 (3.9 – 6.1mmol/L)
    • 17K • Total cholesterol - 8.0mmol/L (<5.2) • LDL cholesterol - 5.7mmol/L (<2.6) • Chol/HDL Chol - 4.4 (up to 4.0)
    • CT BRAIN • Multifocal small cerebral white matter ischemia
    • DRUGS IN WARD DATE ORDERED DATE OFF IV Nootropil 3gm TDS 9/4/13 12/4/13 Tab Cardiprin 1/1 OD 9/4/13 12/4/13 Tab Vascor 20mg ON 9/4/13 12/4/13 Tab Plavix 75mg Daily 9/4/13 12/4/13
    • DRUGS ON DISCHARGE DATE ORDERED Tab Vascor 20mg ON 12/4/13 Tab Cardiprin 1/1 ON 12/4/13
    • Physiotherapy • • • • • • • To normalise muscle tone To restore muscle function To control compensation strategies To maintain muscle length To re-educate balance To retrain walking and restore mobility To maximise functional ability while allowing ongoing neuromuscular recovery
    • NURSING DIAGNOSIS  Knowledge deficit related to management of blood pressure control.
    • SUPPORTING DATA  Patient will verbalize understand regarding the management of blood pressure.  Patient will maintain optimal normal blood pressure.
    • NURSING INTERVENTION  Reinforce about doctor’s explanation.  Monitor blood pressure 4 hourly.
    • NURSING INTERVENTION  Explain the sign and symptom of high blood pressure :  Headache  Blurring vision  Numbness
    • NURSING INTERVENTION  Advise patient on dietary plan and provide :  Low salt diet  Low fat diet
    • NURSING INTERVENTION  Advise patient to do regular follow up.
    • NURSING INTERVENTION  Advise patient to maintain healthy lifestyle :  Avoid stress  Consume healthy diet and avoid salty and high fat food
    • NURSING INTERVENTION  Advise patient to do regular exercise.  Encourage family members support.
    • NURSING INTERVENTION  Explain the complication of high blood pressure :  Influences of cardiovascular  Cerebral  Renal system
    • NURSING DIAGNOSIS  Alteration in emotional status anxiety related to symptoms of stroke and treatment.
    • NURSING DIAGNOSIS  Alteration in ADL related to right sided weakness and numbness of right hand.
    • NURSING DIAGNOSIS  Knowledge deficit related to management of blood glucose control.
    • NURSING DIAGNOSIS  Potential fall related to right sided body weakness.
    • NURSING DIAGNOSIS  Alteration in nutritional status less than body requirement related to nausea, vomiting and dysphagia.
    • NURSING DIAGNOSIS  Potential infection related to intravenous cannulation.
    • NURSING DIAGNOSIS  Knowledge deficit related to post stroke attack management.
    • NURSING DIAGNOSIS  Potential alteration in skin integrity related to immobility.
    • • • • • • • • • Reduce your blood pressure Improve your diet Stop smoking Consider how much alcohol you drink Exercise more Watch your weight Relaxation and stress management Diabetes management